Fri Feb 02 2024

95 articles - From Friday Jan 26 2024 to Friday Feb 02 2024

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Gastroenterology

AGA Clinical Practice Update on Diet and Nutritional Therapies in Patients With Inflammatory Bowel Disease: Expert Review.

BEST PRACTICE ADVICE 12: Breastfeeding is associated with a lower risk for diagnosis of IBD during childhood. A healthy, balanced, Mediterranean diet rich in a variety of fruits and vegetables and decreased intake of ultraprocessed foods have been associated with a lower risk of developing IBD.

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Meta-analysis

meta-analyses and systematic reviews

Aliment Pharmacol Ther

Meta-analysis: Efficacy and safety of fibroblast growth factor 21 analogues for the treatment of non-alcoholic steatohepatitis and non-alcoholic steatohepatitis-related fibrosis.

FGF21 analogues appear as promising agents for the treatment of NASH and NASH-related fibrosis, and they generally seem to be safe and well tolerated.

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Prevalence and impact of alcohol abstinence in alcohol-associated cirrhosis: Systematic review and meta-analysis.

Alcohol abstinence is associated with substantial improvement in overall survival in alcohol-associated cirrhosis. However, only half of the individuals with known alcohol-associated cirrhosis are abstinent.

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Am J Gastroenterol

The Spigelman Staging System and the Risk of Duodenal and Papillary Cancer in Familial Adenomatous Polyposis. A Systematic Review and Meta-Analysis.

The current Spigelman staging system had a low sensitivity for duodenal and papillary adenocarcinoma. Two Spigelman variables (duodenal villous histology and polyp count) and the lack of papilla-specific variables likely contributed to the low sensitivity values for duodenal and papillary cancer, respectively. While clinicians may be familiar with its current form, there is an urgent need to update it.

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Gastrointest Endosc

Impact of study design on adenoma detection in the evaluation of artificial intelligence-aided colonoscopy: a systematic review and meta-analysis.

Either parallel or tandem study design can capture the improvement in ADR resulting from the use of AI-assisted polyp detection systems. Tandem studies powered to detect differences in endoscopic performance through paired comparison may be a resource-efficient method of evaluating new AI-assisted technologies.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Machine learning improves the prediction of significant fibrosis in Asian patients with metabolic dysfunction-associated steatotic liver disease - The Gut and Obesity in Asia (GO-ASIA) Study.

ML with clinical, anthropometric data and simple blood investigations perform better than FIB-4 for ruling out SF in biopsy-proven Asian NAFLD/MASLD patients.

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Am J Gastroenterol

Abdominal Symptom Improvement During Clinical Trials of Tenapanor in Patients With Irritable Bowel Syndrome With Constipation: A Post Hoc Analysis.

Tenapanor significantly reduced abdominal symptoms in patients with IBS-C, particularly pain, discomfort, and bloating measured by AS, compared with placebo.

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Biological agents in the treatment of Crohn's disease: a propensity score-matched analysis from the prospective Persistence Australian National IBD Cohort (PANIC3) study.

This large national prospective database with non-hierarchical prescribing of biological agents did not identify superior persistence of any agent in bio-naïve CD. However, for bio-experienced CD patients, persistence was greater with ustekinumab.

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Effectiveness of Upadacitinib for Patients with Acute Severe Ulcerative Colitis: A Multi-Center Experience.

Upadacitinib along with IV corticosteroids may be an effective treatment for ASUC.

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Endoscopic Surveillance of Intestinal Metaplasia of the Esophagogastric Junction: A Decision Modeling Analysis.

Endoscopic surveillance is costly and can cause harm, however, low-intensity longitudinal surveillance (every 5 years) is cost-effective in populations with higher EGJAC incidence. No surveillance or one-time endoscopic surveillance of patients with EGJIM was cost-effective in low-incidence populations. Future studies to better understand the natural history of EGJIM, identify risk factors for progression, and inform appropriate surveillance strategies are required.

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Forecasting the Incidence and Prevalence of Inflammatory Bowel Disease: A Canadian nationwide analysis.

Over the next decade, the Canadian healthcare systems will contend with the juxtaposition of rising incidence of pediatric IBD and a rising prevalence of overall IBD driven by the aging population.

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IDENTIFICATION OF ACHALASIA WITHIN ABSENT CONTRACTILITY PHENOTYPES ON HIGH-RESOLUTION MANOMETRY: PREVALENCE, PREDICTIVE FACTORS AND TREATMENT OUTCOME.

Despite HRM diagnosis of absent contractility, achalasia is identified in over one in 10 patients regardless of IRP value.

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Low-dose aspirin and prevention of colorectal cancer: evidence from a nationwide registry-based cohort in Norway.

In this nationwide cohort, use of low-dose aspirin was associated with a lower risk of CRC.

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Outcomes of serum food-specific IgG4 to guide elimination diet in patients with eosinophilic esophagitis.

Serum FS- IgG4 to milk, wheat, soy, egg and nuts were present at higher levels in EoE, with targeted elimination resulting in 45% histologic remission rate. Serum FS-IgG4 has potential as a non-invasive biomarker in EoE. When successful, FS-IgG4-led elimination diet can negate need for medications and be viewed more favourably by patients due to its smaller endoscopic burden compared to empirical elimination diets.

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Population-based study of alcohol-related liver disease in England 2001-2018: Influence of socioeconomic position.

Interpretation The increasing ALD incidence in England is a greater burden on individuals of low compared to high socioeconomic position. This finding highlights ALD as a contributor to inequality in health.

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The Time-Dependent Association between Irritable Bowel Syndrome and All-cause and Cause-specific Mortality: A Prospective Cohort Study within the UK Biobank.

We found that earlier during follow-up, having diagnosed IBS was associated with lower mortality risk, and the association attenuated over time. Additional studies to understand whether specific factors, such as lifestyle and healthcare access, explain the inverse association between IBS and mortality are needed.

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Clin Gastroenterol Hepatol

Burden and Treatment of Chronic Upper GI Symptoms and Diagnoses - a Nationwide Study.

Chronic upper GI symptoms and diagnoses account for a high number of annual health care visits, both in primary care and specialty care. While there are several treatments, many these patients are not on any treatments.

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Coconut water induces clinical remission in mild to moderate ulcerative colitis: double-blind placebo controlled trial.

Coconut water was more effective than placebo for induction of clinical remission in patients with mild to moderate UC. The trial was prospectively registered on clinical trials registry India (No CTRI/2019/03/01827).

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Infant ustekinumab Clearance, Risk of Infection, and Development after exposure during pregnancy.

No adverse signals after intrauterine exposure to ustekinumab were observed with respect to pregnancy outcome, infections, or developmental milestones during the first year of life. Infant ustekinumab concentration was not associated with risk of infections. With the ustekinumab clearance profile, live attenuated vaccination from 6 months of age seems of low risk.

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Endosc Int Open

Clinical usefulness of tissue acquisition of pancreatic cystic lesions using an endoscopic ultrasound-guided needle for histological analysis.

EUS-TA with PC20 has high accuracy and technical success with a low AE rate for PCL diagnosis.

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Device-assisted enteroscopy in the surveillance of intestinal hamartomas in Peutz-Jeghers syndrome.

Endoscopic management of small bowel polyps in patients with PJS using DAE is an effective strategy for prophylactic removal of hamartomas. DAE surveillance and endoscopic polypectomy is safe and may decrease the need for repeated laparotomy in patients with PJS.

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EUS-guided laser lithotripsy for pancreatic duct stones after failed conventional pancreatic endotherapy.

Our approach of performing laser lithotripsy under EUS guidance obviates the need for an ESWL procedure; however, it is technically more challenging and requires precision to avoid injury to the pancreas. Further prospective studies are required to evaluate the safety and efficacy of this novel approach and its applicability as either a rescue procedure or in tandem with conventional pancreatic endotherapy modalities.

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Measuring the concordance between endoscopic and histologic inflammation and its effect on IBD-associated dysplasia.

Endoscopic and histologic inflammation are associated with higher odds of finding TVAs and random low-grade, high-grade, and indefinite dysplasia. Concordance between histologic and endoscopic inflammation severity is low.

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Mid-gastric peroral endoscopic myotomy in the treatment of post-sleeve gastrectomy gastric tube twist: Four cases.

MG-POEM shows promise for safe and effective management of post-LSG mid-gastric twist, despite requiring a high level of endoscopic skill to perform submucosal tunneling.

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Risk factors of early adverse events associated with endoscopic ultrasound-guided hepaticogastrostomy using self-expandable metal stent.

EUS-HGS using SEMS demonstrated high technical and clinical success rates. Laser-cut SEMS may be superior in preventing early AEs.

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Endoscopy

Perspectives and awareness of endoscopy healthcare professionals on sustainable practices in gastrointestinal endoscopy: results of the LEAFGREEN survey.

In this survey, ESGE and ESGENA members acknowledge climate change as a major threat to humanity. Further improvement in sustainability beliefs and professional attitudes, reduction in inappropriate GI endoscopy, and rational use of single-use accessories and endoscopes are critically required.

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Gastroenterology

Celiac disease affects 1% of global population - who will manage all these patients? What are criteria to prioritize along risk for complications?

There is a clear need for more personalized and on-demand follow-up based on early treatment response and patient-related factors associated with long-term prognosis. Additional scientific evidence on the optimal implementation of follow-up for pediatric and adulthood celiac disease is nevertheless called for.

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DIAGNOSIS OF SERONEGATIVE AND ULTRASHORT CELIAC DISEASE.

Some additional diagnostic tools have been developed recently, such as assessing of intestinal transglutaminase 2 (TG2) deposits, the flow-cytometry technique, micro-RNA detection or proteomic analysis and they seem to be useful in the identification of complex patients. Further co-operative studies are highly desirable to improve the knowledge of these two still obscure variants of celiac disease.

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Non-host factors influencing onset and severity of celiac disease.

Furthermore, we discuss studies in CeD-relevant animal models that offer mechanistic insights into how diet, the microbiome, and enteric infections modulate CeD pathogenesis. Finally, we address the clinical implications and therapeutic potential of understanding these cofactors, offering a promising avenue for preventive and therapeutic interventions in CeD management.

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Oncogenic fatty acid metabolism rewires energy supply chain in gastric carcinogenesis.

Active Kras expression only in gastric chief cells drives the full spectrum of gastric carcinogenesis. Also, oncogenic metabolic rewiring is an essential adaptation for high energy demand in dysplastic cells.

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Opportunities for Improving Biopsy and Non-Biopsy-Based Diagnosis of Celiac Disease.

Despite the growing popularity and evidence basis for a biopsy-free approach to diagnosis in the context of highly elevated serologies, there will nevertheless continue to be a role for a biopsy in some groups. The present review summarizes the current evidence supporting a non-biopsy approach, arguments supporting continued reliance on biopsy, and focuses on opportunities to improve both approaches.

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Transcriptomic-Based Microenvironment Classification Reveals Precision Medicine Strategies for PDAC.

This novel approach defines a distinct subgroup of PDAC patients that may benefit from immunotherapeutic strategies based on their TME subtype and provides a framework to select patients for prospective clinical trials investigating precision immunotherapy in PDAC. Further, the predictive utility and real-world clinical applicability espoused by this transcriptomic-based TME classification approach will accelerate the advancement of precision medicine in PDAC.

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Gastrointest Endosc

Clinical outcomes of argon plasma coagulation for the treatment of gastric low grade dysplasia.

In gastric LGD smaller than 10 mm without scars, APC is a good treatment modality in place of ER. However, when a lesion is larger, APC should be selected carefully with close monitoring.

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Endoscopic Gastrointestinal Placement of Capsule Endoscopy to Investigate the Small Bowel: a Multicentric European Retrospective Series of 630 Procedures in Adult Patients.

EGIPT of SB CE is highly feasible, safe and comes with high completion rate and diagnostic yield. When indicated, it should rather be performed under anesthesia and the capsule should be delivered in the duodenum rather than in the stomach, for better SB examination outcomes.

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Gastric Cancer Detection Rates using Gastrointestinal Endoscopy with Serological Risk Stratification: A Randomized Controlled Trial.

There were no differences between Ba-Endo and ABC-Endo groups in GC detection rates. However, the rate of detected GCs that could be cured by endoscopic resection alone was significantly higher in the ABC-Endo group.

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Histopathological vertical margin positivity in cold snare polypectomy and mucosal resection for sessile serrated lesions.

A rigorous histopathologic evaluation revealed that for SSLs, CSP more frequently leads to positive vertical margins than EMR.

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Incomplete Mucosal Layer Excision during Endoscopic Mucosal Resection: a potential source of recurrent adenoma.

We report the novel finding of IME within the PED after EMR of LNPCPs. IME may contain microscopic residual adenoma and therefore is a risk for RRA during follow-up. After completion of EMR the PED should be carefully evaluated and if IME is found it should be excised.

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Insulin sensitivity and beta cell function after Duodenal Mucosal Resurfacing (DMR): An Open-Label, Mechanistic, Pilot Study.

Insulin sensitivity and insulin secretion improved 3 months after DMR. It is unlikely that incretin changes are responsible for improved glucose control after DMR. These data add to the growing evidence validating the duodenum as a therapeutic target for patients with T2D.

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LIQUID NITROGEN SPRAY CRYOTHERAPY FOR ERADICATION OF DYSPLASTIC BARRETT'S ESOPHAGUS: RESULTS FROM A MULTICENTER PROSPECTIVE REGISTRY.

In this largest reported prospective cohort, liquid nitrogen SCT was safe and effective for treatment of dysplastic and neoplastic BE. Response was lower in those with prior failed RFA; in that cohort approximately 50% attained CEIM at 3 years.

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Novel endoscopic scoring system for immune mediated colitis: A Multicenter Retrospective Study of 674 Patients.

This is the largest, multi-center study to devise an endoscopic scoring system to guide IMC management. An IMCES cutoff 4 has a higher specificity for SIT use than clinical symptoms, supporting early endoscopic evaluation for IMC.

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Potential for expanding indications and curability criteria of endoscopic resection for early gastric cancer in elderly patients: results from a Japanese multicenter prospective cohort study.

Usefulness of ESD for elderly EGC patients was confirmed by their clinical outcomes. Lesions ≤3 cm and EL-L emerged as new ER indication and curability criterion, respectively.

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SAFETY OF ENDOSCOPIC ULTRASONOGRAPHY LATEX BALLOON USE IN PATIENTS WITH A LATEX ALLERGY.

The use of EUS latex balloons in patients with a latex allergy was associated with no adverse events.

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Gut

Early-life diet and risk of inflammatory bowel disease: a pooled study in two Scandinavian birth cohorts.

In this Scandinavian birth cohort, high diet quality and fish intake in early life were associated with a reduced risk of IBD.

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Optimal age to discontinue long-term surveillance of intraductal papillary mucinous neoplasms: comparative cost-effectiveness of surveillance by age.

The cost-effectiveness of long-term IPMN surveillance depended on sex, IPMN types, and comorbidity levels, suggesting the potential to personalise patient management from the health economic perspective.

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Hepatology

Targeting Src SH3 domain-mediated glycolysis of hepatic stellate cells suppresses transcriptome, myofibroblastic activation, and colorectal liver metastasis.

The Src SH3 domain-facilitated metabolic reprogramming induced by TGFβ1 represents a target to inhibit CAF activation and the pro-metastatic liver microenvironment.

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J Hepatol

Clinical profiles and mortality rates are similar for metabolic dysfunction-associated steatotic liver disease and non-alcoholic fatty liver disease.

NAFLD and MASLD were similar except MASLD subjects were older with slightly higher mortality risk due to cardiometabolic risk factors inclusion. Clinical profiles and NIT thresholds are identical. These data provide evidence that NAFLD and MASLD can be used interchangeably.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Clin Gastroenterol Hepatol

Blue Notes.

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Further progress to quantify histological damage in patients with celiac disease.

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Pharmacoequity for Older Adults With Inflammatory Bowel Diseases.

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Upper GI Endoscopy Off PPI with Concurrent Telemetry Capsule pH monitoring. Evidence Based and Cost Effective.

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Endosc Int Open

Choose the best alternative wisely for biliary interventions after failed ERCP!

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Device-assisted enteroscopy and the need for surgery in Peutz-Jeghers syndrome: the long and winding road.

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J Hepatol

MASLD emerging from the fog of fatty liver.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

A Rare Cause of Abdominal Mass and Constipation.

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A Rare Complication of a Benign Pancreatic Tumor.

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Adult Type II Choledochal Cyst.

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Anorectal Manometry: When, How to Perform and Interpret, and Is It Useful?

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Electrosurgical Principles: Beyond Blue and Yellow Pedal.

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How I Approach It: Prompt Engineering for Generative Artificial Intelligence (GAI) in Gastroenterology and Hepatology.

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Response to Ma et al.

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True, True and Unrelated? A case of two nearby gastric lesions.

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Under the covers - a sharp foreign body buried within the lumen.

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Unveiling the Enigma: A Rare Presentation of S. mansoni Infection Resembling a Rectal Mass.

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Clin Gastroenterol Hepatol

Ethical Implications of Artificial Intelligence in Gastroenterology.

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High Diagnostic Yield of Abnormal Endoscopic Findings in the Evaluation of Laryngopharyngeal Reflux.

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Kissing anal ulcers.

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Pseudolipomatosis of the Colon.

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Endosc Int Open

Percutaneous single-operator cholangioscopy-assisted antegrade biliary recanalization with over-the-wire 3F microcatheter manipulation.

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Endoscopy

Comments on the use of confocal laser endomicroscopy in diagnosing protein-losing enteropathy.

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Cutting-edge novel device in the treatment of obesity.

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ESGE and its publications.

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Endoscopic management of a chronic anastomotic leak after a Billroth II procedure.

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Endoscopic removal of esophageal foreign body embedded in muscularis propria.

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Endoscopic submucosal dissection for diverticulum using combination of countertraction and circumferential-inversion method.

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Endoscopic submucosal dissection for superficial esophageal cancer with ulcer scarring using a combination of pocket creation, gel immersion, and red dichromatic imaging.

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Endoscopic ultrasound-guided drainage using a forward-viewing echoendoscope for peripancreatic fluid collection after Child resection.

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Endoscopy E-Videos - recently published.

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Enhancing visualization with low echo reduction during endoscopic ultrasound-guided pancreatic duct drainage.

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Inspection of intraductal papillary mucinous neoplasm via the papilla using a novel slim pancreatoscope under balloon enteroscopy.

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Multipolar traction pulley method combined with underwater endoscopic submucosal dissection for a large rectal laterally spreading tumor.

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Remarkable tumor shrinkage in hilar biliary cholangiocarcinoma confirmed by peroral cholangioscopy following neoadjuvant chemotherapy.

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Stretching the limits of submucosal tunneling endoscopic resection.

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Therapeutic endoscopy and appendiceal lesions - train and evaluate before intervening.

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Unveiling the hidden threat: esophageal squamous cell neoplasm in patients with head and neck squamous cell carcinoma.

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Gastroenterology

Pharmacoequity for Older Adults With Inflammatory Bowel Diseases.

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Recurrent Abdominal Pain Associated with Small Intestinal Edema.

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Gastrointest Endosc

Clofazimine associated enteropathy.

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Gut

Ebastine for the treatment of irritable bowel syndrome: old drug, new tricks?

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Inflammatory bowel diseases: are we ready to recommend a preventive diet for infants?

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J Hepatol

A rare cause of liver fibrosis in an adult patient.

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From the Editor's Desk...

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Genetic cholestasis in children and adults.

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Letters&Replies

Letters to the editors and authors’ replies

Clin Gastroenterol Hepatol

Artificial Intelligence in Medical Consultations: Optimization in Assessment and Application.

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Prolonged Gastrointestinal Manifestations After Recovery From COVID-19.

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Gut

eCura and W-eCura: different scores, different populations, same goal.

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